Clinical, morphological and immunohistochemical aspects in laryngeal premalignant lesions

Vol. 47 No. 2, 2006

ROMANIAN JOURNAL of MORPHOLOGY and EMBRYOLOGY

Fl. Anghelina, Elena Ioniță, Carmen-Florina Popescu, I. Ioniță, Carmen Mogoantă, S. Ciolofan, L. Mogoantă

Objective. We investigated the proliferative activities in premalignant laryngeal vocal chord lesions treated by epithelial stripping in microlaryngoscopy, using immunohistochemical staining with anti-p53, anti-PCNA and anti-Ki-67 monoclonal antibody and we correlated with clinic and morphologic aspects. Material and methods. The study was made on 32 patients hospitalized in Craiova ENT Clinic in 2005 presenting lesions precursor to vocal cord malignity. The lesion's aspect was observed using suspended microlaryngoscopy, a biopsy was performed and biological tests were examined from a pathological and immunohistochemical point of view, with the investigation of the following immunohistochemical markers: Ki-67, PCNA and p53. Results. Thirteen cases (41%) presented red hypertrofic chronic laryngitis, seven cases (22%) presented white hypertrofic chronic laryngitis, and 12 cases (37%) presented papillomas with simple, moderate, severe dysplasia and in situ carcinoma in 62.5%, 22%, 12.5% and, respectively, 3% of the cases. All the dysplasic lesions, no matter the dysplasic degree, have presented alteration of both surface eplitelium and chorion. The expression of Ki-67, PCNA and p53 was correlated with the dysplasia's degree in various proportions. Conclusions. In clinical practice, morphological grading of dysplasia is difficult to evaluate. The Ki-67 and PCNA markers were correlated with the dysplasia degree; the expression of p53 was present only in 28% cases with moderate dysplasia and in one case with in situ carcinoma.

Corresponding author: Florin Anghelina, MD, PhD, e-mail: dr_anghelina_florin@yahoo.com

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